The Basics
What is Metoprolol?
Used alone or in combination to treat high blood pressure, chest pain and improve survival after a heart attack.
Brand names for Metoprolol
Lopressor
How Metoprolol is classified
Antihypertensive Agents, Adrenergic Beta-Antagonists, Antiarrhythmics
Metoprolol During Pregnancy
Metoprolol pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Metoprolol while pregnant
N/A
Taking Metoprolol While Breastfeeding
What are recommendations for lactation if you're taking Metoprolol?
Because of the low levels of metoprolol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. Studies on the use of metoprolol during breastfeeding have found no adverse reactions in breastfed infants. No special precautions are required.
Maternal / infant drug levels
Because of the low levels of metoprolol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. Studies on the use of metoprolol during breastfeeding have found no adverse reactions in breastfed infants. No special precautions are required.
Possible effects of Metoprolol on milk supply
Relevant published information on the effects of beta-blockade or metoprolol during normal lactation was not found as of the revision date. A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels following beta-adrenergic blockade with propranolol.[13]
Possible alternatives to Metoprolol
Propranolol, Labetalol.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Riant P, Urien S, Albengres E et al. High plasma protein binding as a parameter in the selection of betablockers for lactating women. Biochem Pharmacol. 1986;35:4579-81. PMID: 2878668
2. Kulas J, Lunell NO, Rosing U et al. Atenolol and metoprolol. A comparison of their excretion into human breast milk. Acta Obstet Gynecol Scand Suppl. 1984;Suppl 118:65-9. PMID: 4043203
3. Lindeberg S, Sandstrom B, Lundborg P et al. Disposition of the adrenergic blocker metoprolol in the late-pregnant woman, the amniotic fluid, the cord blood and the neonate. Acta Obstet Gynecol Scand Suppl. 1984;Suppl 118:61-4. PMID: 6587729
4. Sandstrom B, Regardh CG. Metoprolol excretion into breast milk. Br J Clin Pharmacol. 1980;9:518-9. PMID: 7397065
5. Sandstrom B. Antihypertensive treatment with the adrenergic beta-receptor blocker metoprolol during pregnancy. Gynecol Invest. 1978;9:195-204. PMID: 750326
6. Liedholm H, Melander A, Bitzen PO et al. Accumulation of atenolol and metoprolol in human breast milk. Eur J Clin Pharmacol. 1981;20:229-31. PMID: 7286041
7. Yep T, Eyal S, Easterling TR et al. The pharmacokinetics of metoprolol during pregnancy. Pharmacotherapy. 2011;31:439e. Abstract. DOI: doi:10.1592/phco.31.10.311e
8. Ryu RJ, Eyal S, Easterling TR et al. Pharmacokinetics of metoprolol during pregnancy and lactation. J Clin Pharmacol. 2016;56:581-9. PMID: 26461463
9. Sandstrom B, Lindeberg S, Lundborg P et al. Disposition of the adrenergic blocker metoprolol in the late pregnant woman, the amniotic fluid, the cord blood and the neonate. Clin Exp Hypertens B. 1983;2:75-82. PMID: 6135523
10. Grundmann M, Kacirova I, Duricova J, Perinova I. Metoprolol and alfa-hydroxymetoprolol concentrations during lactation – a case report. Ther Drug Monit. 2011;33:504. Abstract. DOI: doi:10.1097/01.ftd.0000400651.94145.ba
11. Ho TK, Moretti ME, Schaeffer JK et al. Maternal beta-blocker usage and breast feeding in the neonate. Pediatr Res. 1999;45:67A. Abstract 385.
12. Schimmel MS, Eidelman AI, Wilschanski MA et al. Toxic effects of atenolol consumed during breast feeding. J Pediatr. 1989;114:476-8. PMID: 2921694
13. Board JA, Fierro RJ, Wasserman AJ et al. Effects of alpha- and beta-adrenergic blocking agents on serum prolactin levels in women with hyperprolactinemia and galactorrhea. Am J Obstet Gynecol. 1977;127:285-7. PMID: 556882
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
